Management of Cardiogenic Shock: Therapeutic Strategiesx

• DOI: https://doi.org/10.22533/at.ed.15952625140713

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• Abstract:

  Cardiogenic shock (CS) is one of the most critical syndromes in cardiovascular medicine, characterized by acute circulatory failure and high mortality, especially after acute myocardial infarction. This article carries out a narrative review of recent literature, focusing on the main pharmacological and mechanical therapeutic strategies applied in the management of CHF. Norepinephrine remains the vasopressor of choice, while the association with dobutamine can be useful in patients with severe ventricular dysfunction. Circulatory support devices such as ECMO-VA and Impella have been used in refractory cases, although with significant risks. Percutaneous revascularization of the culprit lesion remains the only intervention with a proven impact on clinical outcomes. The implementation of multidisciplinary teams and structured protocols has shown an improvement in survival, especially in specialized centers. Finally, the need for an individualized approach, based on clinical phenotype, biomarker stratification and advances such as artificial intelligence, is highlighted in order to overcome the persistent challenges in the management of CHD and reduce its high morbidity and mortality.